INSTRUCTIONAL MANUAL

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1 HEALTH MINISTRY HEALTH CLOSER TO YOU ACCESS AND QUALITY NATIONAL PROGRAM FOR ACCESS AND QUALITY IMPROVEMENT IN PRIMARY CARE (PMAQ) INSTRUCTIONAL MANUAL Brasilia DF 2012

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3 HEALTH MINISTRY HEALTH CLOSER TO YOU ACCESS AND QUALITY NATIONAL PROGRAM FOR ACCESS AND QUALITY IMPROVEMENT IN PRIMARY CARE (PMAQ) INSTRUCTIONAL MANUAL Brasilia DF 2012

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5 HEALTH MINISTRY Primary Care Secretary Primary Care Department HEALTH CLOSER TO YOU ACCESS AND QUALITY NATIONAL PROGRAM FOR ACCESS AND QUALITY IMPROVEMENT IN PRIMARY CARE (PMAQ) INSTRUCTIONAL MANUAL Series A. Standards and Technical Manuals Brasilia DF 2012

6 2012 Health Ministry. All rights reserved. The partial or complete reproduction of this paper is permitted as long as the source is quoted and it is not used for sales or any commercial purpose. The Technical Department is responsible for the copyrights of texts and images in this paper. The Health Ministry s institutional collection can be fully accessed on the Health Ministry s Virtual Health Library: Circulation Amount: 1st edition copies Formulation, distribution and information Health Ministry Health Care Secretary Primary Care Department Edificio Premium, Saf Sul, quadra 2, lotes 5/6, bloco II, subsolo CEP: Brasilia/DF Phones: (61) / Website: General Supervision Hêider Aurélio Pinto General Technical Coordination Allan Nuno Alves de Sousa Technical Review Alexandre de Souza Ramos Aristides Oliveira Eduardo Alves Melo Marina Manzano Capeloza Leite Patrícia Sampaio Chueiri Technical Formulation Aliadne C. Soares de Sousa Allan Nuno Alves de Sousa Aristides Oliveira Carolina Pereira Lobato Cínthia Lociks de Araújo Dirceu Ditmar Klitzke Eduardo Alves Melo Fernando Maia Hêider Aurélio Pinto Patrícia Sampaio Chueiri Régis Cunha de Oliveira Silvia Reis Collaboration Alexandre Teixeira Trino Andréia Gimenez Nonato Vila Danillo Fagner Vicente de Assis Edneusa Mendes Nascimento Edson Hilan Gomes de Lucena Eduardo Augusto Fernandes Nilson Printed in Brazil Catalogue Form Elisabeth Susana Wartchow Elizabeth Regina de Freitas Silva Gilberto Alfredo Pucca Júnior Lucinadja Gomes da Silva Maria Beatriz Kneipp Natali Pimentel Minóia Patrícia Constante Jaime Roberta Maria Leite Costa Rodrigo Cabral da Silva Rosa Maria Sampaio de Carvalho Rosani Pagani Sônia Maria Dantas de Souza Wellington Mendes Carvalho Wesley Fernando Ferrari Editing Coordination Antônio Sérgio Ferreira Marco Aurélio Santana da Silva Renata Ribeiro Sampaio Graphic Project Alexandre Soares de Brito Diogo Ferreira Gonçalves Standardization Marjorie Fernandes Gonçalves Review Ana Paula Reis Brazil. Health Ministry. Health Care Secretary. Primary Care Department National Program for Access and Quality Improvement in Primary Care (PMAQ): instructional manual / Health Ministry. Health Care Secretary. Primary Care Department Brasilia : Health Ministry, p. : il. (Series A. Standards and Technical Manuals) ISBN Primary Care. 2. Health Promotion. 3. Access to health services.i. Title. II. Series. CDU 614 Source Cataloging General Coordination for Documents and Information MS Publishing House OS 2012/0296 Index Titles Portuguese: Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ) Manual Instrutivo Spanish: Salud más cerca de usted Programa Nacional para la Mejoria del Acceso y Calidad en Atención Primário en Salud Manual de instrucciones

7 Abbreviation List AB Primary Care ACS Community Health Worker AMAQ Self-Assessment for Access and Quality Improvement in Primary Care CIB Bipartite Inter-management Commission CIR Regional Inter-management Commission CIT Tripartite Inter-management Commission CMS Municipal Health Council CNES National Registry for Health Establishments Conasems National Council of Municipal Health Secretaries Conass National Council of State Health Secretaries DAB Primary Care Department EAB Primary Care Team ESB Oral Health Team ESF Family Health Strategy GM Ministers Office IBGE Brazilian Institute for Geography and Statistics MS Health Ministry PAB Primary Care Salary Floor PIB Gross Domestic Product PMAQ National Program for Access and Quality Improvement in Primary Care PNAB Primary Care National Policy RAS Primary Care Network SAS Health Care Secretary SF Family Health SGDAB Program Management System of Primary Care Department SIA Ambulatory Information System Siab Primary Care Information System Sisprenatal Monitoring and Evaluation System for Prenatal and Puerperium Sisvan Food and Nutrition Surveillance System Siscolo Information System for Uterine Cervix Cancer SUS Unified Health System TC Declaration of Commitment UBS Basic Health Unit UF Federal Unit

8 Summary 1 National Program for Access and Quality Improvement in Primary Care 7 2 Primary Health Care 13 3 Implementation Phases of the National Program for Access and Quality Improvement in Primary Care Participation and Contracting Commitments Contracting Indicators Criteria for Parameters and Equivalence of the Different Primary Care Organization 29 methods with the Family Health Strategy Limits for Participation and Contracting within the Program Steps for Program Participation in the Program Management System of Primary Care Department (SGDAB) Development Self Assessment Monitoring Continual Education Institutional Support External Assessment Certification of the Primary Care Team Criterias for Certification of the Primary Care Team Criteria for Categorizing the Municipalities for the Primary Care Team Certification Process Contract Renewal 56 References 58

9 1 National Program for Access and Quality Improvement in Primary Care One of the main current guidelines of the Health Ministry (MS) is to run public management based on induction, monitoring and assessment processes as well as measurable results, ensuring health care access and quality to the entire population. In this sense, many efforts have been made in order to adjust the strategies planned out in the Primary Care National Policy (PNAB) in order to recognize the quality of Primary Care (AB) services offered to the Brazilian society and stimulate access and quality expansion in various contexts existing in the country. In recent years, with an estimated coverage of more than half of the Brazilian population through the Family Health Strategy (ESF) and a population coverage through other AB models that may vary between 20% and 40% 1, the issue with management quality and AB team practices has received greater importance on the agenda of the managers from the Unified Health System (SUS). Thus, the MS proposes several initiatives focused on qualifying AB such as the National Program for Access and Quality Improvement in Primary Care (PMAQ) which has been highlighted. The PMAQ was established by Ordinance No GM / MS, July 19, 2011, and was the result of an important negotiation and agreement process involving the three levels of SUS management that included several moments in which the MS and the municipal and state managers, represented by the National Council of Municipal Health Secretaries (Conasems) and National Council of State Health Secretaries (Conass), discussed and formulated solutions for designing a program that would permit access expansion and quality improvement of primary care in all of Brazil. The program s main objective is to induce the access expansion and quality improvement of primary care, with a guaranteed national quality standard, both regional and locally, in order to allow greater transparency and effectiveness of the government actions directed to Primary Health Care. 1 Estimated value considering different calculation methods, based on the amount of Basic Health Units (UBS) that are organized through various primary care methods, which are different than the Family Health Strategy, and / or the number of professionals working in these UBS. 7

10 Among its specific goals, we can highlight: I - Increase AB impact on the population s health conditions and user satisfaction, through strategies for facilitating access and improving the quality of AB services and actions; II - Provide standards for good practices and organization within the UBS that will guide AB quality improvement; III Promote UBS greater compliance with AB principles, increasing effectiveness in the health condition improvements, user satisfaction, health practice quality and the health system s efficiency and effectiveness; IV - Promote quality and innovation within the AB management, strengthening selfassessment processes, monitoring and evaluation, institutional support and continual education within the three government spheres; V - Improving the quality for updating and use of information systems as an AB management tool; VI - Institutionalize an evaluation culture of the AB in the SUS and management based on induction and monitoring of processes and results, and VI Stimulate AB focus on the user, promoting transparency of management processes, participation and social control and health responsibility of the health professionals and managers with the improvement of health conditions and user satisfaction. The commitment for quality improvement should be constantly reinforced with the development and improvements of initiatives that are more appropriate due to the new challenges generated by reality, both because of the increasing complexity of the populations health needs, due to epidemiological and demographic transitions as well as the current sociopolitical context, with the populations increased expectations regarding the efficiency and quality of the SUS. 8

11 The PMAQ is inserted in a context where the federal government gradually develops and undertakes actions aimed towards improving the access and quality of the SUS. Among them, it is important to highlight the Assessment Program for SUS Qualification, which has the main objective of evaluating the results of the new health policy in all of its dimensions, especially for the AB component. It is a model for evaluating health system performance, at all the three government levels, which aims to measure the possible effects of the health policy in order to support decision making, ensure transparency of the management processes in the SUS and generate visibility to the results achieved, as well as strengthen social control and the health system s focus on users. Amongst the challenges PMAQ intends to face for qualifying AB, the following are highlighted: I - Precarious physical infrastructure, with a significant portion of the UBS s in inappropriate conditions; II Unwelcoming Environment of the UBS, providing users with an impression that the services offered are low quality and negatively targeted to the poor population; III - Inadequate working conditions for professionals, compromising their intervention capacity and work satisfaction; IV - The need for qualification of the work processes for the AB teams, characterized generally by their inability to take on acute health problems; insufficient integration of team members; and lack of work orienting based on priorities, goals and results, defined jointly by the staff, municipal management and community; V Team instability and high turnover levels within the team of professionals, compromising bonds, care continuity and team integration; VI Beginning of management processes focused on induction and quality monitoring; 9

12 VII - Overload of teams with too many people under their responsibility, compromising the coverage and quality of their actions; VIII - Low integration of the AB teams with the diagnostic and therapeutic support network as well as with the rest of the Health Care Network (RAS) ; IX - Low completeness and resolution of practices, with the persistence of the complaint - conduct model, prescriptive care, medical- centered-procedure, focused on the biomedical dimension of the health-disease-care process; XI - Insufficient and inadequate financing of the AB, linked to team accreditation, regardless of the results and quality improvement. Considering all of these challenges, as well as the progress achieved through the National Primary Care Policy in recent years, the Health Ministry, with the contribution and incorporating of the state and municipal managers perspective, structured the design of the National Program for Access and Quality Improvement in Primary Care through seven guidelines that govern its organization and development: I Have a comparison parameter between the primary care teams (EAB), considering the different health realities: an important element that must always be present in the process of evaluating health service quality is the presence of mechanisms that ensure the possibility for comparison between health services offered by the different primary care services, respecting the diversity of contexts. II - Be incremental, envisioning a continual and progressive process for the improvement of standards and access and quality indicators that involves management, work processes and the results achieved by the primary health care teams: the choice of the standards and indicators for monitoring and evaluating actions developed by primary care teams considered, initially, a number of aspects that can be measured for all the teams, regardless of the context in which they are inserted. However we anticipate the need, throughout the program s development, to define new standards and indicators that permit 10

13 the continued accumulation and adequacy of the commitments contracted, being consistent with the regional and local specifications. III - Be transparent in all of its stages, allowing continual monitoring of their actions and results, by society: the process for improving health policies presupposes the presence of mechanisms that favor permanent monitoring, by the whole society, of the actions taken by the health services, as well as the results they generate. In this sense, the performance of the municipal 2 management and the EAB participants of the PMAQ may be accompanied by the States, municipalities and organized civil society, among others, through the Primary Care Department portal at the following electronic address dab. IV - Involve, mobilize and make the federal manager, state management, Federal District, municipal and local, teams and users responsible through a management culture change process and qualification of primary care: ever since participation and contracting in the PMAQ, managers and EAB shall be responsible for a series of actions that may qualify the management work process and workers in primary care. Users will also be involved in the program, as they may potentiate the changes through monitoring and discussion regarding the performance of teams and municipal management in locations such as the Local and Municipal Health Councils. Besides this, an important dimension that will be present in the assessment process of the EAB participating in the program will be the evaluation of user satisfaction. V Develop a negotiation and contracting culture involving the management of resources based on the commitments and results agreed upon and achieved: one of the main elements of the PMAQ is the establishment of mechanisms for financing AB by contractual commitments of the EAB, the municipal and state management and linking the resource transfers to team performance. The objective is recognizing the municipal management and AB workers efforts to develop actions that increase access and quality of the services offered to the population. VI - Stimulate effective change in the care model, the development of workers and services focused on needs and user satisfaction: the entire PMAQ design considers the need 2 In this document, the Distrito Federal (Federal District) will be considered a municipality and the local health management of the Distrito Federal will be considered municipal management, as to avoid the Repetition of the DF specification throughout the entire content. 11

14 to recognize the quality of AB produced and offered to the population, in order to induce change in the work process and, consequently, the impact caused by this change on the users and workers. Based on the principles of primary care, the program seeks to encourage the change of the care model based on the understanding that the context conditions, as well as the role of different participants, may produce significant changes in how to care and manage care permitting the EAB qualification. Worker development is also an objective in the program. It seeks to mobilize them, offer strategies for permanent education and encourage the establishment and improvement of mechanisms that ensure rights, stable bonds and qualify work relations. At the same time, the PMAQ seeks to incorporate the user population s perception, as well as invite them to participate, through creating environments for participation, agreement and assessment, which will guide the organization of care based on the concrete needs of the population. VII - Have a voluntary characteristic for membership both in the primary care teams and within the municipal management, assuming that its success depends on the motivation and pro activity of the participants involved: participation in the PMAQ and incorporating processes aimed towards improving access and quality of the AB presupposes the main role of all participants involved in the program implementation process, and the voluntary characteristic for participation is associated with the idea that the strengthening and the introduction of practices related to increasing the quality of AB can only be performed in environments where workers and managers feel motivated and essential to its success. 12

15 2 Primary Health Care Primary health care is characterized by a set of health actions, both individual and collectively, which includes the promotion, protection and restoration of health, with the goal of developing a comprehensive care that will impact the health situation and people autonomy as well as community health determinants and conditions. It is developed with the highest degree of decentralization and capillarity, close to people s lives. It is operated through care and management practices, democratic and participatory, through teamwork, targeting populations in defined territories, and responsible for their health conditions, considering the dynamics in the territory were these populations live. Using complex and varied care technologies that should assist in the management of health needs and demands that are more frequent and relevant in their territory, observing the risk criteria, vulnerability and resilience and the ethical imperative which stated that all demands, health needs or suffering must be cared for. It is the contact and preferential gateway for users in the health care network. It is guided by the principles and guidelines of the SUS and holds specific functions and characteristics. Primary care considers the individual as unique and singular taking into consideration their social cultural integration, seeking to provide comprehensive care through their health promotion, prevention, diagnosis, treatment, rehabilitation and harm or suffering reduction that may compromise their autonomy. The following principles and guidelines are highlighted: I Territorialization and health commitment The territorialization process is a fundamental step in the appropriation / knowledge of the country by the primary care worker teams, where the mapping of the territory occurs from different maps (physical, socioeconomic, health, demographic, social network etc). Through territorialization, it is possible to recognize living conditions and the health situation of the population in one coverage area through a broadened perspective, as well as the collective risks and the territory potential. The dimensions of health commitment regards the responsibility that teams should take on in their performance territory (ascription), considering environmental, epidemiological, cultural and socioeconomic issues, contributing through health actions, as to reduce risks and vulnerabilities. 13

16 II User ascription and bond The user ascription is a process for linking people and / or groups and families to professionals / teams, as a reference for care. The bond, in turn, consists in building affection and trust relationships between the user and the health worker, permitting the deepening of the co-responsibility process for health, built over time, as well as being potentially therapeutic. III - Accessibility, care and preferential gateway The establishment of mechanisms that ensure accessibility and care presupposes an organization and functioning logic for the health service that is based on the principal that the health unit must receive and care for every person seeking its services, in a universal and non excluding manner. The health service should be organized in order to take on its main function which is caring, listening and offering positive responses, capable of solving health problems and / or minimizing harm and suffering, being responsible to offer answers even if they may need to be offered in another unit of the network. The proximity and the ability to provide care, bonds and commitment are fundamental to the effectiveness of primary care as a contact and preferential gateway in the care network. IV Longitudinal Care The longitudinal aspect of care presupposes the continuity of the clinical relationship, building bonds and commitment between professionals and users over time and permanently, monitoring the effects of the health interventions and other elements in the lives of the users, adjusting conducts, when necessary, avoiding referral losses and reducing the risks of iatrogenesis resulting from the lack of knowledge regarding life stories. V - Health Care Network (RAS) Ordination Primary health care should be organized based on the RAS, due to its capillarity and work logic, and must have a key role in organizing the Network. For this, it is necessary to have adequate population coverage and high care capacity, with a high resolution degree. The RAS ordination also 14

17 implies that most of the care flows, care segments and therapeutic and diagnostic support offers are designed and implanted based on the health needs identified by the primary care services. VI - Management of the comprehensive care network The bond built by a solving, humanized and comprehensive primary care enables the gradual development of care management for the users by the teams, in the various scenarios and moments of care, even when the continuity of the care requires being relocated to other care units of the RAS, which is when the primary care coordination is decisive. VII - Work in multi professional team Given the diversity and complexity of situations dealt with by primary care, it is necessary to have / build analysis and intervention capacity amplified amidst the demands and needs for building comprehensive and effective care. This requires the presence of different professional backgrounds and a high degree of coordination between professionals so that not only are the actions shared, but there also occurs an interdisciplinary process in which, increasingly, the nucleus of specific professional expertise will enrich the common field of expertise, thus increasing the whole team s care ability. This organization presupposes that the work process focused on professional procedures will become focused on the user, where care is the ethical and political imperative that organizes the technical scientific intervention. 15

18 3 Implementation Phases of the National Program for Access and Quality Improvement in Primary Care The National Program for Access and Quality Improvement in Primary Care is organized into four phases that complement each other and form a continuous cycle of AB access and quality improvement, namely: 1 - Participation and contracting; 2 - Development; 3 - External Assessment; 4 Contract renewal. 3.1 Participation and Contracting The first phase of the PMAQ is the formal step of joining the program, through contracting commitments and indicators formalized through the primary care teams and municipal managers, and then with the Health Ministry, in a process that involves local, regional and state agreement and the participation of social control Participation and Permanency in the program The Health Ministry, aiming towards qualifying all of the basic care within the country, through a three way agreement process, allows the Family Health teams to participate in the PMAQ, which is a priority strategy for expansion and strengthening AB in Brazil as well as the primary care teams organized differently, provided they fulfill the assumptions and requirements of the program. Thus, all the primary care health workers 3, including oral health, in different methods, may join the PMAQ provided that they are in accordance with the primary care principles 4. 3 The details of the formalization process for participation in the program on the SGDAB are described in item of this instructional document. 4 The parameter and equivalence criterias for the different primary care organization methods with the Family Health Strategy are detailed in item of this instructional document. 16

19 Participation shall be voluntary presupposing an initial agreement process between primary care teams and municipal managers, which should precede the municipality s formal participation process with the Health Ministry. The PMAQ joining process will be permanent and there is no deadline for the EAB and municipal managers to enter the program, except for seven months before the municipal elections. Therefore, in years when municipal elections occur, the Program Management System of Primary Care Department (SGDAB) will be open for PMAQ participation up until the end of February. However, each municipality may only have new primary care team (s) joining the program once a year, with a minimum six month break between one joining process and another. In this first year of program implementation, an exception to the rule will be made, as the registries will take place between the 1st of September and October 31, 2011, and new enrollments for 2012 will be suspended and opened again in Participation in the PMAQ will be done through the SGDAB, which will be available on the DAB website, at / dab. It is important to highlight that each municipality may include all or part of their teams in the program, within the limits for membership and contract signing described in section of this informative. Upon membership approval, performed by the Health Ministry, the municipality will monthly receive, through a fund to fund transfer, 20% of the full value of the Quality Component from the Variable Primary Care Salary Floor (PAB Variable), per participant primary care team considering the competence of the month in which the approval was issued. The full value of the Quality Component of the Variable PAB is equal to $ 6, per primary care team, and may reach up to R$ 8, in cases where there is an Oral Health team linked to the EAB. Thus, each municipality will receive, by joining the program, R$ 1, per EAB an R$ 1, when there is an ESB linked to the EAB 5. After the program s external assessment process, scheduled for phase 4, the amount transferred per EAB will be linked to their performance. 5 These values will be readjusted periodically by the Health Ministry, according to budget availability. 17

20 The Health Ministry will perform the approval for municipalities and EAB that join the program, on a monthly basis, publishing an official order that specifies the municipalities that are participating in the PMAQ, with the respective number of teams. To formalize the The approval of the EAB and joining process for the program, the publishing municipalities that join the program, date of the official order will be considered. through the executive order issued by the MS, will be made at the After the municipality s participation beginning of the month for the group approval, the manager should inform it to the Municipal Health Council (CMS) 6, the Regional of municipalities that fulfill all of the Inter-management Commission (CIR) 7 and steps provided for joining the PMAQ in the Bipartite Inter-management Commission (CIB) 8. It is important to remember that the SGDAB up until the last day of the previous month. this step will not prevent the municipality s participation approval for the PMAQ, nor the transfers of funds linked to the program. However, loading the electronic scanned documents that prove that the municipality has informed their participation to the collegiate mentioned is a condition for requesting the external evaluation process, to be held during the fourth PMAQ phase. In regards to the conditions for remaining in the program, the municipalities will lose accreditation with the PMAQ and will no longer receive the financial incentives in situations where the municipal management does not formalize, via SGDAB, the request for external assessment within a maximum period of six months for the first cycle and 18 months for the next cycles of the program. In such cases, the municipalities will also be prevented from joining the program during a period of two years. This mechanism seeks to prevent participation that is not effectively committed to the full compliance of the program s quality cycle. In turn, EAB permanence in the PMAQ is conditional to: I The same requirements that govern the PAB variable payment provided in the current Primary Care National Policy 9. Managers must register and regularly update information regarding 6 In the Distrito Federal (Federal District), this communication should be performed with the Distrito Federal Health Council. 7 Or commission, council or analog committee, which is present in the State. 8 In the Distrito Federal, this communication should occur with the Management Collegiate of the DF Health State Secretary. 9 In cases were the primary care teams have organization methods that are different then the ESF, similar requirements will 18

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